长期口服小剂量胺碘酮对老年人甲状腺激素及糖、脂质水平的影响

Effect of Amiodarone on blood lipids,glucose and thyroid hormones in the aged

目的：观察长期口服小剂量胺碘酮对老年人甲状腺激素及糖、脂质水平的影响。方法：对１８例需长期服用胺碘酮（平均剂量０．１８±０．０３ｇ／ｄ）的老年心律失常患者，于治疗前及治疗期间定期测定甲状腺激素Ｔ３、Ｔ４、ｒＴ３、ＴＳＨ及血糖、血脂水平。结果：服胺碘酮１年后，Ｔ４、ｒＴ３、ＴＳＨ分别增加１７．１％（Ｐ＜０．０５）、４０．３％（Ｐ＜０．０１）和１５．６％（Ｐ＞０．０５），而Ｔ３减少２８．２％（Ｐ＜０．０５），除ｒＴ３外均在正常范围内波动，无一例出现甲状腺功能异常的临床症状。血糖、甘油三酯无明显变化，总胆固醇增加９．１％，但无统计学意义（Ｐ＞０．０５）。结论：长期口服小剂量胺碘酮对老年人是安全的，对甲状腺激素水平及糖、脂质的代谢均无明显影响。

Objective: To investigate the effects of longterm lowdose Amiodarone (Am) on thyroid function,blood lipids and glucose level in the aged. Methods:Eighteen aged patients with refractory arrythmias requiring Am treatment were studied.The mean daily dose of Am was 0.18±0.03 g.Thyroid hormones(T3,T4,rT3,TSH),plasma lipids and glucose levels were measured periodically before and during the 1 year period of Am therapy. Results:After 1 year of Am therapy,plasma T4, rT3 and TSH levels were increased by 17.1%(P<0.05), 40.3%(P<0.01) and 15.6%(P>0.05) respectively.Compared with those before treatment,T3 was decreased by 28.2% (P<0.05),but all these remained in the normal ranges except rT3. No patients had clinical evidence of altered thyroid state. Mean serum glucose and triglyceride concentrations did not change significantly. Mean serum cholesterol concentration was 9.1% higher after 1 year of Am therapy,but the difference was not significant(P>0.05). Conclusions:Longterm lowdose Am treatment is safe to the aged,it does not have significant effects on thyroid function and lipids and glucose metabolism.